Provider Demographics
NPI:1255923884
Name:ELSAWI, AHMED (PTA)
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:ELSAWI
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MCCLELLEN ST
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07648-1555
Mailing Address - Country:US
Mailing Address - Phone:646-465-0685
Mailing Address - Fax:
Practice Address - Street 1:100 MCCLELLEN ST
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07648-1555
Practice Address - Country:US
Practice Address - Phone:201-768-6222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-04
Last Update Date:2024-11-09
Deactivation Date:2022-06-20
Deactivation Code:
Reactivation Date:2024-10-22
Provider Licenses
StateLicense IDTaxonomies
NY012737225200000X
NJ40QB00418300225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant